Provider Demographics
NPI:1760453757
Name:LOWMAN, DENNIS J (DDS, MS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:LOWMAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 INGERSOLL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-3506
Mailing Address - Country:US
Mailing Address - Phone:515-274-9151
Mailing Address - Fax:515-274-1472
Practice Address - Street 1:3940 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3506
Practice Address - Country:US
Practice Address - Phone:515-274-9151
Practice Address - Fax:515-274-1472
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA057831223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAT00599Medicare UPIN
IA08088Medicare ID - Type Unspecified